Association of radon exposure with lung cancer: serum biomarkers and computed tomography evidence from male miners

The objective of this research is to investigate the association between occupational radon exposure and pulmonary health outcomes in male miners from Chongqing, China. Between June 2022 and December 2023, 110 miners were enrolled in this cross-sectional study. Personal radon exposure levels were measured using passive cumulative dosimeters, with pulmonary health assessed through radiologist-interpreted low-dose computed tomography (CT) scans and serum biomarker analysis (CEA, CYFRA21-1, NSE, and CA125) via ELISA. Multivariable analyses revealed strong dose-response relationships between radon exposure and both serum biomarkers and CT abnormalities. high radon exposure predicted substantial biomarker elevations including a 2.45-fold increase in CYFRA21-1 (β = 0.39, 95 % CI 0.25-0.54, p < 0.001), 1.60-fold increase in CEA (β = 0.20, 0.05-0.35, p = 0.008), and 3.58-fold increased CT abnormality risk (OR = 3.58, p = 0.023). Mediation analysis identified CYFRA21-1 as accounting for 69 % (p = 0.024) and CEA for 24.7 % (p = 0.036) of radon's effect on CT abnormalities. These findings demonstrate that occupational radon exposure contributes to pulmonary damage through both direct effects and biomarker-mediated pathways, with CYFRA21-1 and CEA emerging as potential early indicators of lung cancer in radon-exposed populations.